Background

The primary aim was to investigate outcome of the decision making on duration of injection intervals between injection visits over the first 2 years of a treat and extend regimen.

Method

Consecutive patients receiving Aflibercept for treatment naïve neovascular age-related macular degeneration between 01.01.2016 and 15.07.2017 were identified from our departmental register. Retrospective data collected on all visits over 24 months were classified into three groups: (A) Without Interval Decision Events (IDE)” Injection only” (B) IDE resulting in injection intervals of <5 weeks and (C) IDE resulting in intervals of >5 weeks. The primary outcome was number of successful IDE relative to the total visits in Group C. Successful decision making was defined as absence of worsening of visual acuity (>5 L) or central retinal thickness (>50 microns) at the subsequent visit. Secondary visual and anatomical outcomes at 24 months were also evaluated.

Results

Data from 56 eyes of 50 patients were included in the study. Visual acuity improved by +7.11 L at 24 months. Forty one patients with unilateral therapy made 721 visits: 280 visits (38.8%) were group A; 164 visits (22.8%) were group B and 277 visits (38.4%) were group C. Average interval in Group C was 8.9 weeks (range 5–15). The success rate of extension was 95.31% (264/277 visits).

Conclusion

These metrics for evaluating the decision making aspect of disease activity monitoring may be useful for monitoring performance and have given us a more realistic view and expectations of what can be achieved using this regime to optimise the timing of injections.

中文翻译：

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用于评估新生血管性年龄相关性黄斑变性“治疗和延长”方案决策的新指标

背景

主要目的是调查治疗和延长治疗方案的前 2 年中注射就诊之间的注射间隔持续时间的决策结果。

方法

从我们的科室登记册中确定了2016年1月1日至2017年7月15日期间连续接受阿柏西普治疗的初治新生血管性年龄相关性黄斑变性的患者。24 个月内所有就诊收集的回顾性数据分为三组：(A) 无间隔决策事件 (IDE)“仅注射”(B) IDE 导致注射间隔 <5 周，(C) IDE 导致注射间隔>5周。主要结果是 C 组中成功 IDE 的数量相对于总就诊次数。成功的决策定义为在随后的就诊中视力（> 5 L）或中央视网膜厚度（> 50 微米）没有恶化。还评估了 24 个月时的二次视觉和解剖结果。

结果

该研究纳入了 50 名患者 56 只眼睛的数据。24 个月时视力提高了 +7.11 L。41 例单侧治疗患者共 721 次就诊：A 组 280 次就诊（38.8%）；B 组有 164 次就诊 (22.8%)，C 组有 277 次就诊 (38.4%)。C 组的平均间隔为 8.9 周（范围 5-15）。延期成功率为95.31%（264/277次就诊）。

结论

这些用于评估疾病活动监测决策方面的指标可能有助于监测性能，并使我们对使用该方案优化注射时间可以实现的目标有了更现实的看法和期望。